According to Hayden (2006), PPIs can suppress over 90 percent of stomach acid production. She added that when the dose is adjusted correctly, these drugs become very effective in eliminating symptoms of GERD – even becoming more effective than H2 blockers at healing severe inflammation of the esophagus. Risks Apparently, there are doctors who have concerns about the risk of using proton pump inhibitors to reduce stomach acid production on a long-term basis long time.

However, Hayden (2006) has argued that there are people who have used omeprazole for up to 12 years with no sign whatsoever that any significant problems were caused by the reduced production of stomach acid. She added that patients who develop symptoms several hours after taking a PPI would probably require one of several therapeutic approaches depending upon their symptoms. For example, if they develop heartburn while on PPIs, an adjustment of the dose or using a PPI with longer half-life may be necessary. But if patient complains about nausea, bloating or early satiety, a prokinetic agent should be the added to the drug of choice.

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If the PPI dose has already been increased and the dopamine receptor metoclopropamide has been added but the patient still complains about heartburn, burping or regurgitation, it may be due to bile reflux – which PPIs cannot eliminate. In these kinds of situations, antacids may be helpful in neutralization. Some patients, on the other hand, suffer from visceral hypersensitivity syndrome (unusual sensitivity to events) plus GERD – making them fail in responding adequately to some treatment methods. These people may benefit from the additional prescription of low dose tricyclic antidepressants.

She said PPIs are approved for long-term use in Canada, Europe, and the United States, adding that for the very small number of people to whom PPIs do not work well, other treatments for GERD can always be tried References Cash, B. (2005) “Proton-Pump Inhibitors in the Treatment of Gastroesophageal Reflux Disease and Related Conditions. ” Medscape. Retrieved March 26, 2009 from http://www. medscape. com/viewarticle/506616 Fisichella, P. M. (2008, July 17). “Gastroesophageal Reflux Disease. ” E Medicine. Retrieved March 26, 2009 from http://emedicine. medscape. com/article/176595-overview Hayden, M. (2006)

“Proton pump inhibitors for gastroesophageal reflux disease (GERD). ” Yahoo Health. Retrieved March 26, 2009 from http://health. yahoo. com/gerd-medications/proton-pump-inhibitors-for-gastroesophageal-reflux-disease-gerd/healthwise–hw96384. html Marks, J. (2008, October 9). “Proton-Pump Inhibitors (PPIs). ” Medicine. Net. Retrieved March 26, 2009 from http://www. medicinenet. com/proton-pump_inhibitors/article. htm Marks, J. (2009) “Gastroesophageal Reflux Disease (GERD, Acid Reflux, Heartburn). ” Medicine. Net. Retrieved March 26, 2009 from http://www. medicinenet. com/gastroesophageal_reflux_disease_gerd/article. htm